Reference Citations Research Articles

Exploring Adult Patients’ Perceptions and Experiences of Telemedicine Consultations in Primary Care: A Qualitative Systematic Review

The COVID-19 pandemic transformed a gradual uptake of telemedicine, into a sudden worldwide implementation of telemedicine consultations. Primary care is a particular area affected and one where telemedicine consultations are expected to be the future. However, for effective long-term implementation it is vital that patient perceptions and experiences are understood. The aim of this qualitative systematic review was to explore the perceptions and experiences of adults who have used telemedicine consultations in primary care. Studies were identified through a search of four electronic databases (MEDLINE, EMBASE, CINAHL, and CENTRAL) alongside reference list and citation searches. Quality assessment was conducted using the CASP checklist and data was synthesized using a simplified approach to thematic analysis. From 2492 identified records, ten studies met the eligibility criteria all of which were judged as either good or moderate quality. Three themes were identified which were potential benefits, potential barriers, and beneficial prerequisites for telemedicine consultations in primary care. Within these themes, sixteen sub-themes were identified with examples including accessibility and convenience for potential benefits, lack of face-to-face interaction and impersonal consultations for potential barriers, and continuity of care for beneficial prerequisites. Analysing these subthemes, four main recommendations for practice can be made which are to utilise continuity of care, offer both video and telephone consultations, provide adequate support, and that healthcare professionals should demonstrate an explicit understanding of the patient’s health issues. Further research is needed to explore and expand on this topic area and future research should be viewed as a continuous process.

The Trend of ‘Cyber Technology Ethical’, 1996-2021 in Elementary School: Bibliometric Approach

Transformation of research on cyber character education regarding Islamic education from 1996 to 2021. The purpose of this research is to find out the implementation of character education for students, especially in elementary schools and analyze the trend of publication of Islamic education in elementary schools in the 21st century era . The research method used is qualitative research using VOSviewer application analysis in bibliographic reviews taken from the most productive authors, journals, keywords, and citation references analyzed from 1996-2021. The information was obtained from the Google Scholar Science Citation Index database. Qualitative methodology was used in the investigation using the Vosviewer and Nvivo plus 12 applications. The results of the research on the cyber trend of education show that character education is still far from expectations towards society 5.0. The conclusion of the research illustrates that students must be made a top priority in welcoming the industrial era as the nation's next generation, especially among elementary schools. The implication is that there is a contribution in the latest innovation model that cannot be separated from the role model of education that is virtuous and integrated in the future era.

Meta-analysis of gemcitabine plus nab-paclitaxel combined with targeted agents in the treatment of metastatic pancreatic cancer.

BACKGROUNDGemcitabine plus nab-paclitaxel (GA) is a commonly used first-line treatment regimen for metastatic pancreatic cancer, and many studies will add a novel targeted agent to this regimen for improving patient survival rate. However, the clinical effectiveness of GA is the most controversial issue. AIMTo compare the efficacy and safety of GA regimen with a targeted agent and GA regimen.METHODSUp to 1 December 2021, the eligible randomized controlled trials (RCTs) relating to GA and GA with a targeted agent were searched on PubMed, EMBASE and Cochrane Library for eligible data. We screened out appropriate studies for overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and toxicity, which had been pooled and finally analyzed by using Stata version 15.1. In addition, we use Reference Citation Analysis (https://www.referencecitationanalysis.com/) to collect the latest related literature to improve the latest cutting-edge research results.RESULTSSeven RCTs involving 1544 patients (848 men and 696 women) were included. There were no significant differences between GA with a targeted agent and GA in PFS [hazard ratio (HR): 1.18 95% confidence interval (CI): 0.91-1.53], OS (HR: 1.12 95%CI: 0.99-1.27), and ORR (HR: 0.96 95%CI: 0.71-1.29). There was no notable difference in the two groups in grade 3/4 toxicity (fatigue, anemia, vomiting and neutropenia), whereas the incidence of grade 3/4 diarrhea considerably increased in GA with a targeted drug.CONCLUSIONAdding a novel targeted agent to the GA regimen did not improve survival rate of patients with metastatic pancreatic cancer.

Association of electrocardiographic markers with myocardial fibrosis as assessed by cardiac magnetic resonance in different clinical settings.

BACKGROUNDCardiac magnetic resonance (CMR) is a unique tool for non-invasive tissue characterization, especially for identifying fibrosis. AIMTo present the existing data regarding the association of electrocardiographic (ECG) markers with myocardial fibrosis identified by CMR - late gadolinium enhancement (LGE).METHODSA systematic search was performed for identifying the relevant studies in Medline and Cochrane databases through February 2021. In addition, we conducted a relevant search by Reference Citation Analysis (RCA) (https://www.referencecitationanalysis.com).RESULTSA total of 32 studies were included. In hypertrophic cardiomyopathy (HCM), fragmented QRS (fQRS) is related to the presence and extent of myocardial fibrosis. fQRS and abnormal Q waves are associated with LGE in ischemic cardiomyopathy patients, while fQRS has also been related to fibrosis in myocarditis. Selvester score, abnormal Q waves, and notched QRS have also been associated with LGE. Repolarization abnormalities as reflected by increased Tp-Te, negative T-waves, and higher QT dispersion are related to myocardial fibrosis in HCM patients. In patients with Duchenne muscular dystrophy, a significant correlation between fQRS and the amount of myocardial fibrosis as assessed by LGE-CMR was observed. In atrial fibrillation patients, advanced inter-atrial block is defined as P-wave duration ≥ 120 ms, and biphasic morphology in inferior leads is related to left atrial fibrosis.CONCLUSIONMyocardial fibrosis, a reliable marker of prognosis in a broad spectrum of cardiovascular diseases, can be easily understood with an easily applicable ECG. However, more data is needed on a specific disease basis to study the association of ECG markers and myocardial fibrosis as depicted by CMR.

Utility of cardiac bioenzymes in predicting cardiovascular outcomes in SARS-CoV-2.

BACKGROUNDCardiovascular complications have been increasingly recognized in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associated coronavirus disease 2019 (COVID-19). Cardiac biomarkers are released because of this ongoing cardiovascular injury and can act as surrogate markers to assess the disease severity.AIMTo review the variation and utility of these biomarkers in COVID-19 to ascertain their role in diagnosis, prognosis and clinical outcomes of the disease. METHODSWe performed a literature search in PubMed, Medline and the Reference Citation Analysis (RCA), using the search terms “COVID-19” and “cardiac bioenzymes” or “cardiac biomarkers”. Additionally, we also used the latest reference citation analysis tool to identify more articles.RESULTSCardiac troponin has been consistently elevated in patients with COVID-19 associated myocarditis, and strongly correlated with adverse prognosis. Natri-uretic peptides including brain natriuretic peptide (BNP) and pro-BNP is elevated in patients with COVID-19 associated cardiac injury, irrespective of their prior heart failure status, and independently correlated with worst outcomes. Alongside these traditional biomarkers, novel cardiac bioenzymes including presepsin, soluble ST2 and copeptin, are also increasingly recognized as markers of cardiovascular injury in COVID-19 and can be associated with poor outcomes.CONCLUSIONAssessment of cardiac bioenzymes at admission and their serial monitoring can help assess the severity of disease and predict mortality in patients with SARS-CoV-2 infection. Future studies are needed to elude the critical importance of novel biomarkers.

Mortality rate of COVID-19 infection in end stage kidney disease patients on maintenance hemodialysis: A systematic review and meta-analysis.

BACKGROUNDCoronavirus disease 2019 (COVID-19) has been the most talked-about disease of the past few years. Patients with significant comorbidities have been at particular risk of adverse outcomes. This study looked at the outcomes and risk factors for adverse outcomes among patients on chronic hemodialysis for end-stage renal disease, a group of patients known to be particularly susceptible to infectious complications.AIMTo assess outcomes and risk factors for adverse outcomes of COVID-19 infection among patients on chronic hemodialysis.METHODSWe searched PubMed/MEDLINE, EMBASE, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Web of Science databases for relevant terms and imported the results into the Covidence platform. From there, studies were assessed in two stages for relevance and quality, and data from studies that satisfied all the requirements were extracted into a spreadsheet. The data was then analyzed descriptively and statistically.RESULTSOf the 920 studies identified through the initial database search, only 17 were included in the final analysis. The studies included in the analysis were mostly carried out during the first wave. We found that COVID-19 incidence among patients on hemodialysis was significant, over 10% in some studies. Those who developed COVID-19 infection were most likely going to be hospitalized, and over 1 in 5 died from the infection. Intensive care unit admission rate was lower than the infection lethality rate. Biochemical abnormalities and dyspnea were generally reported to be associated with adverse outcomes.CONCLUSIONThis systematic review confirms that patients on chronic hemodialysis are very high-risk individuals for COVID-19 infections, and a significant proportion was infected during the first wave. Their prognosis is overall much worse than in the general population, and every effort needs to be made to decrease their exposure.

Microvessel density in differentiated thyroid carcinoma: A systematic review and meta-analysis.

BACKGROUNDMicrovessel density (MVD) has been proposed as a direct quantification method of tumor neovascularization. However, the current literature regarding the role of MVD in differentiated thyroid carcinoma (DTC) remains inconclusive. AIMTo appraise the effect of tumoral MVD on the survival of patients with DTC. METHODSThis meta-analysis was based on the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The electronic databases Medline, Web of Science, and Scopus were systematically screened. A fixed-effects or random-effects model was used, according to the Cochran Q test. The data were then extracted and assessed on the basis of the Reference Citation Analysis (https://www.referencecitationanalysis.com/).RESULTSA total of nine studies were included in the present study. Superiority of low MVD tumors in terms of 10-year disease free survival (OR: 0.21, 95%CI: 0.08–0.53) was recorded. Lowly vascularized thyroid cancers had a lower recurrence rate (OR: 13.66, 95%CI: 3.03–61.48). Moreover, relapsing tumors [weighed mean difference (WMD): 11.92, 95%CI: 6.32–17.52] or malignancies with regional lymph node involvement (WMD: 8.53, 95%CI: 0.04–17.02) presented with higher tumoral MVD values. CONCLUSIONMVD significantly correlates with the survival outcomes of thyroid cancer patients. However, considering several study limitations, further prospective studies of higher methodological and quality level are required.

Role of the circulatory interleukin-6 in the pathogenesis of gliomas: A systematic review.

BACKGROUNDGlioma is the most common primary tumor in the brain originating from glial cells. In spite of extensive research, the overall survival rate is not enhanced. A number of published articles observed differentially circulating levels of cytokines in glioma. Interleukin-6 (IL-6) protein coded by IL-6 gene is regulated by the immune system and it has been found to have a significant role in progression and apoptosis resistance of glioma. AIMTo review the role of circulatory IL-6 in the development and progression of glioma and its utility as a biomarker. METHODSPreferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were applied to filter the relevant studies based on inclusion and exclusion criteria. We used a combination of keywords and the Reference Citation Analysis (RCA) tool to search the potential studies and performed data extraction from selected studies.RESULTSThe published results were inconsistent; however, most studies showed a significantly higher IL-6 level in glioma cases as compared to controls. Comparative IL-6 level among the different grades of glioma showed a higher level with low-grade gliomas and lower level with high-grade gliomas. CONCLUSIONIL-6 level significantly differed between cases and controls, and among different cancer stages, which shows its potential as a diagnostic and prognostic marker.

Return to work following shoulder arthroplasty: A systematic review

BACKGROUNDMany patients prioritize the ability to return to work (RTW) after shoulder replacement surgeries such as total shoulder arthroplasty (TSA), reverse TSA (rTSA), and shoulder hemiarthroplasty (HA). Due to satisfactory clinical and functional long-term outcomes, the number of shoulder replacements performed will continue to rise into this next decade. With younger individuals who compose a significant amount of the workforce receiving shoulder replacements, patients will begin to place a higher priority on their ability to RTW following shoulder arthroplasty.AIMTo summarize RTW outcomes following TSA, rTSA, and HA, and analyze the effects of workers’ compensation status on RTW rates and ability.METHODSThis systematic review and analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search regarding RTW following shoulder arthroplasty was performed using four databases (PubMed, Scopus, Embase, and Cochrane Library), and the Reference Citation Analysis (https://www.referencecitationanalysis.com/). All studies in English relevant to shoulder arthroplasty and RTW through January 2021 that had a level of evidence I to IV were included. Nonclinical studies, literature reviews, case reports, and those not reporting on RTW after shoulder arthroplasty were excluded.RESULTSThe majority of patients undergoing TSA, rTSA, or HA were able to RTW between one to four months, depending on work demand stratification. While sedentary or light demand jobs generally have higher rates of RTW, moderate or heavy demand jobs tend to have poorer rates of return. The rates of RTW following TSA (71%-93%) were consistently higher than those reported for HA (69%-82%) and rTSA (56%-65%). Furthermore, workers’ compensation status negatively influenced clinical outcomes following shoulder arthroplasty. Through a pooled means analysis, we proposed guidelines for the average time to RTW after TSA, rTSA, and HA. For TSA, rTSA, and HA, the average time to RTW regardless of work demand stratification was 1.93 ± 3.74 mo, 2.3 ± 2.4 mo, and 2.29 ± 3.66 mo, respectively.CONCLUSIONThe majority of patients are able to RTW following shoulder arthroplasty. Understanding outcomes for rates of RTW following shoulder arthroplasty would assist in managing expectations in clinical practice.

Evolution of evidence in spinal surgery - past, present and future Scientometric analysis of randomized controlled trials in spinal surgery.

BACKGROUNDSpine surgery is evolving and in the due course of its evolution, it is useful to have a comprehensive summary of the process to have a greater understanding to refine our future directives. With the multiple domains of research in the spine, it has become difficult for a surgeon to find the potential hotspots in research or identify the emerging research frontiers.AIMTo analyze RCTs (1990–2019) for potential research domains along with their research networks and identify the hot topics for future research.METHODSA comprehensive and systematic analysis of all the RCTs published on spinal surgery from 1990 to 2019 retrieved from the Web of Science Core Collection database. Scientometric and visual analysis of their characteristics, cooperation networks, keywords, and citations were made using CiteSpace software. Journal and article impact index were retrieved from Reference Citation Analysis (RCA) Database.RESULTSA total of 696 RCTs were published on spinal surgery from 1990 to 2019; of which, the United States (n = 263) and China (n = 71) made a significant contribution. Thomas Jefferson University (n = 16) was the leading contributor to RCTs on spinal surgery. Weinstein JN was the most cited author in the field followed by Deyo RA. Spine (n = 559) remained the top-cited journal for RCTs on spinal surgery. On literature co-citation analysis, spinal stenosis, anterior cervical discectomy and fusion, degenerative disc disease, and minimally invasive decompression were identified as the hotspots and potential research frontiers.CONCLUSIONThe identified hotspots that extending the frontiers in the management of degenerative disorders of the spine through further research holds the potential for advancement in spinal care.

Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic

Management of colorectal cancer (CRC) was severely affected by the changes implemented during the pandemic, and this resulted in delayed elective presentation, increased emergency presentation, reduced screening and delayed definitive therapy. This review was conducted to analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic on management of CRC and to identify the changes made in order to adapt to the pandemic. We performed a literature search in PubMed, Medline, Index Medicus, EMBASE, SCOPUS, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Google Scholar using the following keywords in various combinations: Colorectal cancer, elective surgery, emergency surgery, stage upgrading, screening, surveillance and the COVID-19 pandemic. Only studies published in English were included. To curtail the spread of COVID-19 infection, there were modifications made in the management of CRC. Screening was limited to high risk individuals, and the screening tests of choice during the pandemic were fecal occult blood test, fecal immunochemical test and stool DNA testing. The use of capsule colonoscopy and open access colonoscopy was also encouraged. Blood-based tests like serum methylated septin 9 were also encouraged for screening of CRC during the pandemic. The presentation of CRC was also affected by the pandemic with more patients presenting with emergencies like obstruction and perforation. Stage migration was also observed during the pandemic with more patients presenting with more advanced tumors. The operative therapy of CRC was altered by the pandemic as more emergencies surgeries were done, which may require exteriorization by stoma. This was to reduce the morbidity associated with anastomosis and encourage early discharge from the hospital. There was also an initial reduction in laparoscopic surgical procedures due to the fear of aerosols and COVID-19 infection. As we gradually come out of the pandemic, we should remember the lessons learned and continue to apply them even after the pandemic passes.

Certain sulfonylurea drugs increase serum free fatty acid in diabetic patients: A systematic review and meta-analysis.

BACKGROUNDSulfonylurea (SU) is a commonly used antidiabetic drugs effective for type 2 diabetes mellitus. Previous studies have reported that the SU treatment could alter the serum free fatty acid (FFA) concentration in diabetic patients; however, their exact effects remain unknown.AIMTo assess the impact of SU on the FFA level in diabetic patients.METHODSA systematic literature search was conducted by consulting the PubMed, EMBASE, Cochrane Library, Reference Citation Analysis (https://www.referencecitationanalysis.com/), and Web of Science databases from January 1, 1991 to July 30, 2021. Either a fixed-effects model or random-effects model was applied to study the association between SU treatment and FFA concentration according to the heterogeneity test. Two investigators independently performed data extraction. The mean difference (MD) and corresponding 95% confidence interval (CI) were used to measure effect size. R3.5.1 software was utilized for conducting statistical analyses.RESULTSA total of 13 studies with 2273 individuals were selected. Results indicated that FFA concentration increased slightly after treatment with SU (MD = 0.08, 95%CI: 0.03-0.12, P < 0.01). In addition, we found that SU treatment combined with other antidiabetics could also increase the concentration of serum FFA (MD = 0.14, 95%CI: 0.01-0.28, P < 0.01). Regarding the type of SU, there was no significant difference in FFA concentration with glimepiride or glibenclamide. FFA concentration was higher at ≥ 12 wk (MD = 0.09, 95%CI: 0.04-0.13) but not at < 12 wk (MD = 0.01, 95%CI: -0.07-0.09).CONCLUSIONSU treatment could increase the serum FFA concentration in diabetic patients. The fundamental underlying mechanism still needs further investigation.

Mapping the global research landscape on insulin resistance: Visualization and bibliometric analysis.

BACKGROUNDInsulin resistance is a risk factor for metabolic syndromes and is associated with a wide variety of metabolic illnesses, including obesity, type 2 diabetes, and cardiovascular disease.AIMTo investigate and map global insulin resistance studies.METHODSA bibliometric methodology was applied to the literature retrieved from the Scopus database and Reference Citation Analysis (https://www.referencecitationanalysis.com) by using a validated search strategy. The study period was limited from 2002 to 2021. Bibliometric indicators and mapping were presented.RESULTSA total of 26808 articles on the topic of insulin resistance were included in the Scopus database. The articles included research articles (n = 21918; 81.76%), review articles (n = 2641; 9.85%), and letters (n = 653; 2.44%). During the study period, 136 countries contributed to the research on insulin resistance. The highest number of articles was from the United States (n = 7360; 27.45%), followed by China (n = 3713; 13.85%), Japan (n = 1730, 6.45%), Italy (n = 1545; 5.54%), and the United Kingdom (n = 1484; 5.54%). The retrieved articles identified two main research themes: “inflammatory mechanisms in the regulation of insulin resistance” and “mechanisms linking obesity to insulin resistance”.CONCLUSIONOur data show that insulin resistance has steadily gained interest from researchers, as evidenced by the number of citations and yearly publications. Publications have grown significantly in the last decade, while low-income countries with greater burdens continue to produce fewer publications in this field. This approach might assist researchers in choosing new research areas and recognizing research hotspots and frontiers. In the future, perhaps high-quality clinical evidence will be acquired.

Implementation Of Public Moral Values Based On Pancasila As The Strenght Of The Nation Rising From The Covid-19 Pandemic Period

An abstract must accompany each manuscript; This abstract must be completely consistent on its own (eg, without numbers, tables, equations or reference citation), not exceeding 250 words and written as a paragraph. The abstract should include research background, objectives, methodology, and findings. The national identity and character of the Indonesian nation is none other than Pancasila which reflects certain concepts, principles and values contained in it. The character of the Indonesian nation also means the spiritual self of the Indonesian nation which is reflected in the mindset, attitude and pattern of action that characterizes the citizens of the Indonesian nation. In Pancasila, public moral values are reflected in the concept of Jonathan David Haidt, an American social psychologist, containing the principles of Care (Second Precept), Fairness (Fifth Precept), Liberty (Fifth Precept), Loyalty (Third Precept), Authority (Fifth Precept), Fourth Precept), Sanctity (First Precept). The implementation of public moral values originating from Pancasila can be seen in the lives of our people when facing the Covid-19 pandemic. This is what prompted the author to examine this problem with the formulation of the problem, can the implementation of public moral values derived from Pancasila give strength to the Indonesian nation to rise from the Covid-19 pandemic? By using a literacy study approach, this study concludes that the implementation of public moral values originating from Pancasila can provide strength for the Indonesian people to face and rise from the Covid-19 pandemic.

Global research trends in the field of liver cirrhosis from 2011 to 2020: A visualised and bibliometric study.

BACKGROUNDLiver cirrhosis is the leading cause of liver-related mortality worldwide. It is currently a global health challenge.AIMThis research intended to explore and analyse research trends and frontiers in this field during the last 10 years, providing new inspiration for clinical decision-making and scientific research.METHODSPublications on hepatic cirrhosis research were retrieved from the Web of Science Core Collection on April 4, 2021. Bibliometric visualisation was conducted through VOSviewer and CiteSpace.RESULTSThe analytic research was based on original articles and reviews. A total of 7775 records of hepatic cirrhosis published from 2011 to 2020 were retrieved. In the past ten years, the number of related annual publications has increased significantly, especially in the United States and China. All publications were distributed among 109 countries. The United States contributed the most (21.95%) and was consistently the leading driving force, with a solid academic reputation in this area. The University of Barcelona distributed the most related articles (177 articles) and was cited the most frequently. The Journal of Hepatology ranked third in the top 10 journals, which has the highest impact factor (impact factor 2019 = 20.582). Jasmohan S. Bajaj was the most productive author (72 articles). Burst keywords (e.g., sofosbuvir, burden, care, sarcopenia, chronic liver failure, human gut microbiome, and nonalcoholic fatty liver disease) and a succession of reference citation bursts have provided clues about research frontiers in recent years.CONCLUSIONThis study identified developing trends in the evolution of liver cirrhosis to provide new inspiration for researchers.

Lymphocytic choriomeningitis virus: An under-recognized congenital teratogen.

BACKGROUNDLymphocytic choriomeningitis virus (LCMV) is a neglected rodent-borne arenavirus associated with transplacental transmission and fetal infection. AIMTo summarize the epidemiological, clinical, and diagnostic features of reported patients with congenital LCMV infection.METHODSA literature search was conducted in PubMed, Medline, Google Scholar, and ResearchGate. The keywords used were ‘congenital lymphocytic choriomeningitis virus,’ and 48 studies were included. In addition, we conducted a relevant search by Reference Citation Analysis (RCA) (https://www.referencecitationanalysis.com).RESULTSThe results have shown 27 reports of congenital LCMV infection in 86 patients, with 52.73% of them being males. Patients presented with chorioretinitis (83.53%), hydrocephalus (54.12%), and psychomotor retardation or developmental delay (54.12%). Computed tomography and/or magnetic resonance imaging most often demonstrated ventriculomegaly (74.07%), periventricular calcifications (66.67%), and microcephaly (40%). Most mothers of congenitally infected infants were exposed to rodents during pregnancy, predominantly mice, with flu-like symptoms mainly occurring during the first two trimesters of gestation. Mortality in congenitally infected children was 16.47%. The diagnosis of congenital LCMV infection was confirmed serologically in most patients (86.67%).CONCLUSIONLCMV is still an insufficiently recognized fetal teratogen that often leads to long-term neurologic sequelae. Clinicians need to be familiar with LCMV and its potential teratogenic effect and as well as to effectively differentiate LCMV from other TORCH (T: Toxoplasma gondii, O: Other pathogens, R: Rubella virus, C: Cytomegalovirus, H: Herpes simplex virus) pathogens.

How to select the quantitative magnetic resonance technique for subjects with fatty liver: A systematic review.

BACKGROUNDEarly quantitative assessment of liver fat content is essential for patients with fatty liver disease. Mounting evidence has shown that magnetic resonance (MR) technique has high accuracy in the quantitative analysis of fatty liver, and is suitable for monitoring the therapeutic effect on fatty liver. However, many packaging methods and postprocessing functions have puzzled radiologists in clinical applications. Therefore, selecting a quantitative MR imaging technique for patients with fatty liver disease remains challenging.AIMTo provide information for the proper selection of commonly used quantitative MR techniques to quantify fatty liver. METHODSWe completed a systematic literature review of quantitative MR techniques for detecting fatty liver, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Studies were retrieved from PubMed, Embase, and Cochrane Library databases, and their quality was assessed using the Quality Assessment of Diagnostic Studies criteria. The Reference Citation Analysis database (https:// www.referencecitationanalysis.com) was used to analyze citation of articles which were included in this review.RESULTSForty studies were included for spectroscopy, two-point Dixon imaging, and multiple-point Dixon imaging comparing liver biopsy to other imaging methods. The advantages and disadvantages of each of the three techniques and their clinical diagnostic performances were analyzed. CONCLUSIONThe proton density fat fraction derived from multiple-point Dixon imaging is a noninvasive method for accurate quantitative measurement of hepatic fat content in the diagnosis and monitoring of fatty liver progression.

Prospective Science Teachers' Skills in Exploring Reference Sources of Scientific Articles through Science Education Research Methodology Course

Prospective science teachers' research proposals are still weak in reference sources because citations from national or international journals are still lacking. The main weakness comes from the reference sources and citation methods. This study aims to measure prospective science teachers' skills in exploring reference sources for scientific articles. Exploratory skills in this research are limited to organizing a theoretical review for a thesis proposal. This research uses mixed methods. Quantitative data is obtained from the score of research proposals prepared by 34 prospective science teachers as research targets, while qualitative data is from analyzing reference sources in research proposals. Each prepares one proposal so that there are 34 research proposals studied. From the results of the proposal assessment, prospective science teachers are still weak in using references that meet the criteria of &gt;80% of journals and reference publication years that meet the criteria of &gt;80% of publications in the last ten years. The study concludes that learning that equips prospective teachers in preparing research proposals requires a curriculum review. Students need more profound knowledge about references, starting from getting to know journals, selecting articles, looking for articles' findings, citing, and compiling a bibliography.

Gallbladder neuroendocrine carcinoma diagnosis, treatment and prognosis based on the SEER database: A literature review.

BACKGROUNDGallbladder neuroendocrine carcinoma (GB-NEC) has a low incidence rate; therefore, its clinical characteristics, diagnosis, treatment and prognosis are not well explored. AIMTo review recent research and analyze corresponding data in the Surveillance Epidemiology and End Results (SEER) database. METHODSData of GB-NEC (n = 287) and gallbladder adenocarcinoma (GB-ADC) (n = 19 484) patients from 1975 to 2016 were extracted from the SEER database. Survival analysis was performed using Kaplan–Meier and Cox proportional hazards regression. P < 0.05 was considered statistically significant. We also reviewed 108 studies retrieved from PubMed and Reference Citation Analysis (https://www.referencecitationanalysis.com/). The keywords used for the search were: "(Carcinoma, Neuroendocrine) AND (Gallbladder Neoplasms)". RESULTSThe GB-NEC incidence rate was 1.6% (of all gallbladder carcinomas), male to female ratio was 1:2 and the median survival time was 7 mo. The 1-, 2-, 3- and 5-year overall survival (OS) was 36.6%, 17.8%, 13.2% and 7.3% respectively. Serum chromogranin A levels may be a specific tumor marker for the diagnosis of GB-NEC. Elevated carcinoembryonic antigen, carbohydrate antigen (CA)-19-9 and CA-125 levels were associated with poor prognosis. Age [hazard ratio (HR) = 1.027, 95% confidence interval (CI): 1.006–1.047, P = 0.01] and liver metastasis (HR = 3.055, 95% CI: 1.839–5.075, P < 0.001) are independent prognostic risk factors for OS. Patients with advanced GB-NEC treated with surgical resection combined with radiotherapy and/or chemotherapy may have a better prognosis than those treated with surgical resection alone. There was no significant difference in OS between GB-NEC and GB-ADC.CONCLUSIONThe clinical manifestations and prognosis of GB-NEC are similar to GB-ADC, but the treatment is completely different. Early diagnosis and treatment are the top priorities.

How the COVID-19 pandemic has affected the colorectal cancer screening in Italy: A minireview.

The coronavirus disease 2019 (COVID-19) pandemic has caused detrimental effects on many aspects of healthcare practice. Screening programs for the commonest malignancies, namely colorectal cancer (CRC), breast cancer and cervical cancer have been discontinued or interrupted since the beginning of restriction measures aimed to limit transmission of the new coronavirus infection. Robust evidence exists in favour of the role of screening campaigns in reducing mortality from CRC. In fact, the majority of pre-malignant lesions of the colon and rectum can be diagnosed with colonoscopy and treated by endoscopic or surgical resection. Besides, colonoscopy screening allows the diagnosis of CRCs in their pre-clinical stage. Italy was one of the first European countries where a high level of COVID-19 infections and deaths was observed, and one of the first where lockdowns and strict measures were adopted to reduce the risk of COVID-19 diffusion among the population. A systematic review of the literature was performed, including the PubMed, Scopus, Web of Sciences, and Reference Citation Analysis databases, with the aim of critically evaluating the impact of the COVID-19 pandemic on CRC screening in Italy. We found that reduction of CRC screening activity surpassed 50% in most endoscopic units, with almost 600000 fewer CRC screening exams conducted in the first 5 mo of 2020 vs the same period of 2019. While the consequences of the discontinuation of endoscopy screening for the prognosis and mortality of CRC will be evident in the next few years, recent data confirm that CRC is currently treated at a more advanced stage than in the pre-COVID-19 era. Since delays in CRC prevention and early diagnosis may translate to increased CRC-specific mortality, world healthcare systems should adopt strategies to maintain the regularity of CRC screening during subsequent peaks of the COVID-19 pandemic, or future events that might hamper screening programs.